CDC reports on four states' collective public health response to a rabid
kitten during summer 2007

CDC published "Public Health Response to a Rabid
Kitten--Four
States, 2007" in the January 4 issue of MMWR. Portions of the
article are reprinted below.

On July 24, 2007, the South Carolina Department of Health and
Environmental Control (SCDHEC) was notified by the North
Carolina Division of Public Health (NCDPH) of a stray, rabid
kitten that had been handled by players on several girls'
softball teams during a tournament in Spartanburg County, South
Carolina. This report summarizes the public health response to
exposure to the rabid kitten and highlights the importance of
multistate collaboration in a rabid animal investigation.

During July 13-15, 2007, the South Atlantic Summer Showdown
softball tournament was held at a recreational complex in
Spartanburg County. Softball games were held at four
recreational facilities. Approximately 60 teams of approximately
12 players each from multiple states participated in this
tournament. Spectators at the tournament included families and
friends of the softball players and tournament coordinators and
staff members.

On July 14, a softball coach from a North Carolina team found an
apparently healthy and alert kitten in a barrel-shaped garbage
bin located near one of the playing fields at which the
tournament was held. The kitten was placed in a box and later
brought to at least six different games played at two
recreational facilities that same day. That evening, the kitten
was transported by the coach in her private vehicle to her home
in Buncombe County, North Carolina. On July 15, the kitten began
behaving abnormally and became increasingly lethargic. The
coach's housemate brought the kitten to an emergency animal
hospital in Buncombe County for care. Although further
investigation would reveal that the housemate had been bitten by
the kitten, she did not disclose this to the attending
veterinarian at the time of the visit. After evaluation
indicated that the kitten was severely ill, the kitten was
euthanized and held for cremation, planned for July 18. Rabies
was not suspected by the attending veterinarian.

On July 18, the mother of a softball player from North Carolina,
after learning from the coach that the kitten had become ill and
was subsequently euthanized, contacted the emergency animal
hospital and asked whether the kitten had been tested for
rabies. The mother had been bitten while trying to feed the
kitten during the tournament. Rabies testing had not been
planned by the animal hospital because the coach's housemate had
signed a routine release form indicating the kitten had not
bitten anyone during the preceding 10 days. The mother went to
the clinic, requested the cat's body, and took it in her private
vehicle to her local health department. On July 20, the local
health department sent the body to the North Carolina State
Laboratory for Public Health for rabies testing. On July 23, the
kitten had rabies diagnosed by direct fluorescent antibody
testing. The rabies virus was identified as the eastern United
States raccoon variant by rabies monoclonal antibody typing.

The mother provided her travel history to NCDPH, which then
contacted SCDHEC on July 23 to alert the department about the
possible human rabies exposures in Spartanburg County. NCDPH and
SCDHEC obtained a roster of teams from the tournament organizer
and discovered that Georgia, North Carolina, South Carolina, and
Tennessee all had teams participating in the tournament. NCDPH
and SCDHEC contacted CDC and state public health authorities in
Georgia and Tennessee, and all four states subsequently
initiated contact investigations; these investigations sought to
identify and locate potentially exposed persons and ensure that
only persons with actual exposures (i.e., contact with saliva,
either through a bite, a lick on the oral or nasal mucosa, or a
claw scratch) received postexposure prophylaxis (PEP). SCDHEC
coordinated the interstate investigation and led its own
intrastate investigation to locate persons, assess exposures,
and prescribe PEP as warranted; in South Carolina, PEP is
provided by the state to exposed persons as determined by
SCDHEC.

To locate potentially exposed persons, each state issued
advisories (e.g., through daily emails) to local health
departments; additionally, South Carolina, Georgia, and North
Carolina used local news media to alert the public and solicit
responses from potentially exposed persons. South Carolina also
activated the state's 2-1-1 telephone information system, which
uses media channels to advise the public to call a dedicated
state telephone number (2-1-1) for information related to
specific public health emergencies. . . .

This investigation highlights the need for rabies-prevention
measures, such as continued rabies vaccination among
domesticated animals and wild animal populations. The
investigation also demonstrates the importance of interstate
collaboration during a rabies response. Exposed persons were
identified through cooperation among the states and CDC, which
included daily conference calls and email exchanges among
investigators in the affected states; CDC participated in
conference calls to provide additional expertise. In this
investigation, rapid, open, interstate collaboration enabled the
expeditious identification and prophylactic treatment of exposed
persons while preventing unnecessary administration of PEP.

Time's running out: January 25 is the early-bird registration deadline for
the 2008 National Immunization Conference

Yikes! Here it is January 7 and you haven't
registered for this
year's National Immunization Conference (NIC). Lucky for you,
the people in charge at NIC have posted everything you need
online. Read on for answers to pressing questions:

Where is it and when is it? NIC is scheduled for March 17-20 in
Atlanta.

What does registration cost and how do I register?
The fee for
early-bird registration is $200. Wait until January 26, and it's
$225 for standard registration; wait until March 1, and it's
$250 for onsite registration. To register online, go to:http://conferences.taskforce.org/nic

FDA's 4-page publication "A Parent's Guide to
Kids' Vaccines" is
a boon to health professionals who provide vaccination services
to infants, children, and teens. The guide briefly makes the
case for vaccination, explains the role parents play in
vaccinating their children, and gives basic information on the
15 single-antigen or combination vaccines commonly given to
people age 18 years and younger.

Important: Be sure to give influenza vaccine throughout the influenza
season--from now through spring

Influenza vaccination should continue through the
early months
of 2008. Visit the following websites often to find the
information you need to keep vaccinating. Both are continually
updated with the latest resources.

Reminder: CDC's series on Epidemiology and Prevention of VPDs ceases live
broadcast; DVD and Internet formats planned

The satellite broadcast series Epidemiology and
Prevention of
Vaccine-Preventable Diseases has been presented at least once a
year since 1995. Because of escalating costs and limited
availability of the CDC broadcast facility, the series will no
longer be presented as a live broadcast. Beginning in 2008, this
training program will be available only on DVD and by Internet.

The 2008 series is expected to be available in late spring.
Future issues of NCIRD's electronic newsletter Immunization
Works and IAC's IAC Express will keep readers informed as
specific details are made available.

Conference on Vaccine Research scheduled for May 5-7 in Baltimore; abstracts
due February 15

CDC published "Notice to Readers: 11th Annual
Conference on
Vaccine Research" in the January 4 issue of MMWR. The notice is
reprinted below in its entirety.

CDC and 11 other national and international agencies and
organizations will collaborate with the National Foundation for
Infectious Diseases in sponsoring the 11th Annual Conference on
Vaccine Research: Basic Science, Product Development, and
Clinical and Field Studies, to be held May 5-7, 2008, at the
Marriott Waterfront Hotel, Baltimore, Maryland. The conference
is the largest scientific forum devoted exclusively to the
research and development of vaccines and related technologies
for prevention and treatment of disease through immunization,
bringing together human and veterinary vaccinology researchers.
Twenty-two invited speakers will appear at five special symposia
on innate immunity, cutaneous vaccination, adjuvants, universal
influenza vaccination, and recently licensed vaccines. Six oral
sessions and posters will include presentations selected through
peer review from submitted abstracts. Eligible abstracts will be
considered for the Maurice R. Hilleman Early-Stage Career
Investigator Award, which provides $10,000 for research expenses
and a travel stipend and registration for the 2009 conference.

Use
of the new International Certificate of Vaccination or Prophylaxis is required
for yellow fever vaccine

CDC published "Notice to Readers: Requirements
for Use of a New
International Certificate of Vaccination or Prophylaxis for
Yellow Fever Vaccine" in the January 4 issue of MMWR. The notice
is reprinted below in its entirety.

In response to the 2005 revision of the International Health
Regulations (IHR 2005), as of December 15, 2007, a new
International Certificate of Vaccination or Prophylaxis (ICVP)
has replaced the old certificates. The new certificate provides
space for potential certification of additional types of
vaccination or prophylaxis to protect against newly emerging or
reemerging diseases or other events of public health importance.
However, the only vaccination currently required to be indicated
on the ICVP is for yellow fever.

Yellow fever vaccine is required under IHR 2005 by certain
countries for entry, and the new ICVP is required for any yellow
fever vaccination administered beginning December 15, 2007.
Persons vaccinated before that date may use the old certificate
until it expires 10 years from the date of vaccination.

CDC published "Errata: Vol. 56, No. 49" in the
January 4 issue
of MMWR. The errata correct pneumonia and influenza mortality
data that MMWR reported on December 14, 2007. The correction is
reprinted below in its entirety.

This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No.
6NH23IP22550) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.